Short- and Long-Term Structural Characterization of Cured-in-Place Pipe Liner with Reinforced Glass Fiber Material.

Cured-in-place pipe (CIPP), as a kind of trenchless sewer rehabilitation technology, is a method to repair sewer pipe using unsaturated polyester resin. This study develops a CIPP liner using hot water or steam curing as well as glass fiber, in contrast to traditional methods, which use nonwoven fabric. Composite material samples were fabricated by combining liner materials using various methods, and the structural characteristics of the liners were compared and analyzed through short- and long-term flexural strength tests. A long-term test was conducted for 10,000 h, and the results revealed 13.3 times higher flexural strength and 8 times higher flexural modulus than the American Society for Testing Materials minimum criteria for CIPP short-term properties. The maximum creep retention factor was 0.64, thereby reducing the design thickness of the CIPP by up to 54%. The structural characteristics also improved when glass fibers were mixed with traditional CIPP liner, making it possible to reduce the thickness by 30%. Glass fibers result in high structural strength when combined with unsaturated polyester resin. Structural strength increased, even when glass fibers were mixed with traditional CIPP liner. The main contribution of this research is the development of a high strength CIPP liner and improvement of the structural properties of CIPP lining without using the specially formulated resin or lining materials.

Removal of Hydrogen Sulfide in Septic Tanks for Treating Black Water via an Immobilized Media of Sulfur-Oxidizing Bacteria.

In South Korea, the installation of septic tanks for treating black water (STBW) is regulated even in sewage treatment areas to prevent the black water deposition in combined sewers. STBWs in which black water is anaerobically decomposed generate high concentrations of hydrogen sulfide (H2S). In this study, an immobilized media of sulfur-oxidizing bacteria (SOB) was used to remove the H2S. SOB media was prepared by using activated sludge collected from a wastewater treatment plant. Prior to field application, an appropriate cultivation period and aeration rate for SOB activation were estimated through a laboratory-scale test. The SOB was activated after a 23-day cultivation period and an aeration rate of 0.25 L-water/L-air/min. Moreover, the maximum H2S removal efficiency was observed at a cultivation period of 43 days and an aeration rate of 0.38 L-water/L-air/min. Then, the SOB media was installed on STBWs of various capacities. The H2S removal efficiency was compared between with and without SOB media. The maximum H2S elimination capacity with SOB media was 12.3 g/m3/h, which was approximately three times higher than without SOB media. Furthermore, the energy efficiency and oxidation rate were also three times higher with SOB, demonstrating the applicability of SOB for H2S removal in STBW.

Effects of pH on the simultaneous removal of hydrogen sulfide and ammonia in a combined absorption and electro-oxidation system.

Biogas commonly contains both H2S and NH3, and these impurities need to be removed before use. In this study, a combined system consisting of an absorption column and an electro-oxidation reactor was developed to simultaneously treat H2S and NH3. In particular, the effect of the pH (6, 8, and 10) on the system performance was investigated. The mass transfer rate of H2S from the gas to liquid phases was sensitive to pH because of its relatively low solubility at low pHs, while more than 99% of the introduced NH3 was steadily absorbed. Therefore, a pH higher than 8 was favorable for the simultaneous removal of both gases. In the electro-oxidation reactor, H2S was primarily oxidized, while the NH3 oxidation started after H2S was completely eliminated. Furthermore, the oxidation rate and current efficiency of both H2S and NH3 increased with decreasing pH value. The results showed that a low pH was advantageous for the electro-oxidation. In conclusion, the mass transfer rate and oxidation kinetics should be balanced to increase the simultaneous removal of H2S and NH3. Therefore, among the tested pH values, the best performance in the combined system was achieved using a pH of 8.

Simultaneous removal of hydrogen sulfide and ammonia using a combined system with absorption and electrochemical oxidation.

Hydrogen sulfide (H2S) and ammonia (NH3), common impurities in biogas, need to be removed before utilizing it. In this study, a combined system, which consisted of an absorption column and an electrochemical oxidation reactor, was tested to simultaneously remove these impurities. The effects of the current density and the chemical loading rate on the system performance were investigated. Firstly, the mass transfer coefficients for the absorption column were determined at various gas flow rates. More mass of NH3 was transferred, compared with that of H2S, because of its higher solubility. In the electro-oxidation reactor, reactive chlorine species (RCSs) were generated and oxidized both H2S and NH3; however, NH3 started to degrade only after H2S was completely eliminated. At a current density of 400 A/m2, the current efficiencies of H2S and NH3 were 23.1% and 5.9%, respectively. In the combined system, the removal efficiency of H2S was closely related to the mass ratio of the H2S transferred and the RCSs generated. The removal efficiency of H2S was greater than 99% when the ratio was less than 1. The mass transfer potential and the oxidation kinetics should be balanced to improve the system performance for the simultaneous removal of H2S and NH3.

Empowerment as a Predictor of HIV Testing Among Married Women in Nepal.

We examined the association of women empowerment and HIV testing in Nepalese women. Data from the 2012 Nepal Demographic and Health Survey provided a sample of 6,579 females ages 15-49 years. Women empowerment subcategories included participation in decision making, attitudes about safer sex negotiation, and sexual autonomy. Only 454 participants (6.9%) had been tested for HIV. Of note, 41.3% had high participation in decision making, 84.5% showed positive attitudes about safer sex negotiation, and 71.8% scored high in sexual autonomy. After adjusting potential confounders, the odds of being tested were higher for women with positive attitudes about safer sex negotiation (adjusted odds ratio = 1.444, 95% confidence interval: 1.006-2.072, p = .046) and high sexual autonomy (adjusted odds ratio = 3.138, 95% confidence interval: 1.375-7.164, p = .007). Age, education, and wealth were independent factors determining the women's HIV testing approach. Our study can be a guide for interventions and policies to empower women and encourage HIV testing in Nepal.

Relationship Between Catastrophic Health Expenditures and Income Quintile Decline.

OBJECTIVES: The aims of this study were to investigate the proportion of households facing catastrophic health expenditures based on household income quintiles, and to analyze the relationship between expenditures and household income quintile decline. METHODS: Study data were obtained from an annually conducted survey of the 2012-2013 Korean health panel. There were 12,909 subjects aged 20-64 years from economically active households, whose income quintile remained unchanged or declined by more than one quintile from 2012 to 2013. Logistic regression analysis was performed to determine whether catastrophic health expenditures in 2012 were related to more than one quintile income decline in 2013. RESULTS: Households facing catastrophic health expenditures of ≥ 40%, ≥ 30%, and ≥ 10% of a household's capacity to pay, were 1.58 times (p < 0.003), 1.75 times (p < 0.000), and 1.23 times (p < 0.001) more likely to face a decline in income quintile, respectively. CONCLUSION: Over a 1 year period, the proportion of households facing more than one quintile income decline was 16.4%, while 2.1% to 2.5% of households in Korea faced catastrophic health expenditures. Catastrophic health expenditure experienced in 2012 was significantly associated with income quintile decline 1 year later. Therefore, lowering the proportion of households with catastrophic health expenditure may reduce the proportion of households with income quintiles decline.

Nurse-Perceived Patient Adverse Events depend on Nursing Workload.

OBJECTIVES: The purpose of this study was to investigate the correlation between nursing workload and nurse-perceived patient adverse events. METHODS: A total of 1,816 nurses working in general inpatient units of 23 tertiary general hospitals in South Korea were surveyed, and collected data were analyzed through multilevel logistic regression analysis. RESULTS: Among variables related to nursing workload, the non-nursing task experience had an influence on all four types of patient adverse events. Nurses with non-nursing tasks experienced patient adverse events-falls [odds ratio (OR) = 1.31], nosocomial infections (OR = 1.23), pressure sores (OR = 1.16), and medication errors (OR = 1.23)-more often than occasionally. In addition, when the bed to nurse ratio was higher, nurses experienced cases of pressure sores more often (OR = 1.35). By contrast, nurses who said the nursing workforce is sufficient were less likely than others to experience cases of pressure sores (OR = 0.78). Hospitals with a relatively high proportion of nurses who perceived the nursing workforce to be sufficient showed a low rate of medication error (OR = 0.28). CONCLUSION: The study suggested that the high level of nursing workload in South Korea increases the possibility of patient adverse events.

Dental Care Utilization for Examination and Regional Deprivation.

OBJECTIVES: Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization. METHODS: Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258). RESULTS: Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (p<0.001). However, this relationship was not shown with dental care utilization for other reasons in the final model. CONCLUSIONS: This study's findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination.

Unmet healthcare needs depending on employment status.

OBJECTIVES: The purpose of study is to find relevance between unmet healthcare needs and employment status and if factors have relevance to unmet healthcare needs due to "economic burden" and "no time to spare". METHODS: The study conducted a survey of 9163 respondents who said they needed a medical treatment or checkup were asked why the need for care was unmet. RESULTS: 22.9% of the respondents said they did not receive a medical treatment or checkup they needed at least once. The rate of unmet healthcare needs caused by "economic burden" was higher among temporary workers (ORs=2.13), day workers (ORs=1.92). However, the rate of unmet needs due to "no time to spare" was lower for temporary workers (ORs=.58) than for regular workers, studies (ORs=.33), housework (ORs=.26), early retirement (ORs=.19) and disease or injury (ORs=.07). CONCLUSION: Non-regular waged workers were more likely to have an unmet need for healthcare due to "economic burden" than regular waged workers. On the other hand, regular waged workers were less likely to receive necessary healthcare services due to "no time to spare" than non-regular waged workers and economically inactive people.

Does type D personality affect symptom control and quality of life in asthma patients?

AIMS AND OBJECTIVES: This study aims to identify the effects of type D personality on symptom control and quality of life and to explore factors influencing quality of life among asthma patients in Korea. BACKGROUND: Psychological factors such as depression and stress are well known to be related to medical outcomes and quality of life in asthma patients. People with type D personality are vulnerable to stress, show poor prognosis in disease and experience low quality of life. DESIGN: A descriptive cross-sectional design was used. METHODS: A total of 144 patients with asthma participated in this study. Data were collected through face-to-face interviews using structured questionnaires: the Type D Personality Scale-14, Asthma Control Test and Asthma-Specific Quality of Life. RESULTS: About 33% of participants were classified into the type D personality group. The type D personality group showed statistically significantly lower symptom control and asthma-specific quality of life compared to the non-type D personality group. Based on forward stepwise multiple regression, the most significant factor of quality of life was symptom control, followed by type D personality, hospitalisation within the previous one year, and lifetime hospitalisation experiences. CONCLUSIONS: The prevalence of type D personality in asthma patients was high, and type D personality was significantly associated with poor symptom control and low quality of life. Psychosocial interventions might be beneficial to improve symptom control and quality of life in asthma patients with type D personality. RELEVANCE TO CLINICAL PRACTICE: Nurses should be aware of the high prevalence of type D personality and the effects on symptom control and quality of life in asthma patients. Nurses should also provide personality-specific interventions to improve quality of life in such patients.

Influencing effect of non-motor symptom clusters on quality of life in Parkinson's disease.

The heterogeneity of non-motor symptoms (NMSs) in patients with Parkinson's disease (PD) has been well established. We investigated the effects of NMS as a cluster on the quality of life (QoL) of patients with PD. We recruited 180 patients with PD and used a descriptive cross-sectional study design. To determine interrelationships between non-motor symptoms, a principal component analysis with varimax rotation was performed based on the Non-Motor Symptoms Scale (NMSS). Among 180 PD patients, 172 patients (96.6%) had experienced at least 2 domains of concurrent non-motor symptoms. There were two types of non-motor symptom clusters (NMSCs). The first non-motor symptom cluster (NMSC1) consisted of mood, sleep/fatigue, attention/memory, urinary symptoms, and miscellaneous symptoms, while the second non-motor symptom cluster (NMSC2) consisted of perceptual problems, gastrointestinal issues, and cardiovascular symptoms. The elderly PD patients were more often categorized as experiencing NMSC2 than NMSC1. Our subgroup cluster analysis showed that PD patients with higher scoring NMS had significantly poorer QoL in both NMSC1 and NMSC2 subgroups, with subgroup-specific patterns. NMSCs also emerged differently depending on sex and the severity of PD. In conclusion, PD patients with NMS may have a specific cluster pattern of NMSC. Some NMSCs may have a negative impact on QoL. Understanding the clinical implications of NMSC in PD patients may provide better therapeutic interventions.

Influence of the nursing practice environment on job satisfaction and turnover intention.

OBJECTIVES: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. METHODS: Among the 11 731 nurses who participated in the Korea Health and Medical Workers' Union's educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. RESULTS: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses' job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses' turnover intention. CONCLUSIONS: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses' job satisfaction. However, the nursing practice environment was not related to nurses' turnover intention.

Nurse-perceived patient adverse events and nursing practice environment.

OBJECTIVES: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. METHODS: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. RESULTS: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician- nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. CONCLUSIONS: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

Reliability and validity of the Korean version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire to assess Chemotherapy-induced peripheral neuropathy.

PURPOSE: This study was performed to assess the reliability and validity of the Korean version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Chemotherapy-induced peripheral neuropathy 20 items (EORTC QLQ-CIPN20) in patients receiving neurotoxic chemotherapy. METHODS: A convenience sample of 249 Korean cancer patients, previously or currently, being treated with peripheral neurotoxic chemotherapeutic agents were asked to fill in the questionnaire. Collected data were analyzed using SPSS 21.0 and AMOS 21.0. Construct validity, known-group validity, concurrent validity, and internal consistency reliability of the Korean version of the QLQ-CIPN20 were evaluated. RESULTS: Factor analysis confirmed 3 dimensions of CIPN: sensory, motor, and autonomic. The factor loadings of the 20 items on the 3 subscales ranged from .38 to .85. The 3 subscale-model was validated by confirmatory factor analysis (GFI=.90, AGFI=.86, RMSR=.05, NFI=.87, and CFI=.94), and concurrent validity was demonstrated with the EORTC QLQ-C30. Furthermore, the QLQ-CIPN20 established known-group validity. The Cronbach's alpha coefficients for internal consistency of the subscales ranged from .73 to .89. CONCLUSION: The Korean version of the EORTC QLQ-CIPN20 showed satisfactory construct, concurrent, and known-group validity, as well as internal reliability.

Adsorption characteristics of siloxanes in landfill gas by the adsorption equilibrium test.

Due to the increase in energy cost by constantly high oil prices and the obligation to reduce greenhouse effect gases, landfill gas is frequently used as an alternative energy source for producing heat and electricity. Most of landfill gas utility facilities, however, are experiencing problems controlling siloxanes from landfill gas as their catalytic oxidizers are becoming fouled by silicon dioxide dust. To evaluate adsorption characteristics of siloxanes, an adsorption equilibrium test was conducted and parameters in the Freundlich and Langmuir isotherms were analyzed. Coconut activated carbon (CA1), coal activated carbon (CA2), impregnated activated carbon (CA3), silicagel (NCA1), and activated alumina (NCA2) were used for the adsorption of the mixed siloxane which contained hexamethyldisiloxane (L2), octamethylcyclotetrasiloxane (D4), and decamethylcyclopentasiloxane (D5). L2 had higher removal efficiency in noncarbon adsorbents compared to carbon adsorbents. The application of Langmuir and Freundlich adsorption isotherm demonstrated that coconut based CA1 and CA3 provided higher adsorption capacity on L2. And CA2 and NCA1 provided higher adsorption capacity on D4 and D5. Based on the experimental results, L2, D4, and D5 were converted by adsorption and desorption in noncarbon adsorbents. Adsorption affinity of siloxane is considered to be affect by the pore size distribution of the adsorbents and by the molecular size of each siloxane.

Application of revised nursing work index to hospital nurses of South Korea.

PURPOSE: Based on the Revised Nursing Work Index (NWI-R), this research aimed to develop a Korean Hospital General Inpatient Unit-Nursing Work Index (KGU-NWI). This study also aimed to compare the common points and differences between the subfactors of the KGU-NWI and the subfactors from previous studies. METHODS: Based on opinions from 3,151 nurses in Korean hospital general inpatient unit, this research used 57 items of NWI-R and the principal axis factor analysis for deriving subfactors. We evaluated the convergent validity through factor analysis and the content validity of KGU-NWI in terms of the association between nurses' job outcome and the subfactors derived. RESULTS: Six subfactors and 26 items for KGU-NWI were derived from NWI-R. Among them, 'physician-nurse relationship', 'adequate nurse staffing' and 'organizational support and management of hospital' were the same with results from previous studies. In addition, two subfactors, 'participation of decision-making processes' and 'education for improving quality of care', which were similar with results from previous Korean studies, were newly added by using Korean hospital cases. In contrast to previous Korean studies, a unique subfactor this study found was 'nursing processes'. This research confirmed that the six subfactors were highly correlated with job satisfaction, intention to leave, and quality of health care, which represented a nurse's job outcome. CONCLUSION: KGU-NWI including six subfactors and 26 items is an applicable instrument to investigate nurse work environment in Korean hospital general inpatient unit.

Insulin pump therapy in transient neonatal diabetes mellitus.

Neonatal diabetes mellitus (NDM) is a rare disease requiring insulin treatment. Its treatment is primarily focused on maintaining adequate glycemic control and avoiding hypoglycemia. Although insulin pump therapy is frequently administered to adults and children, there is no consensus on the use of insulin pumps in NDM. A 10 day-old female infant was referred to us with intrauterine growth retardation and poor weight gain. Hyperglycemia was noted, and continuous intravenous insulin infusion was initiated. However, the patient's serum glucose levels fluctuated widely, and maintaining the intravenous route became difficult within the following weeks. Continuous subcutaneous insulin infusion with an insulin pump was introduced on the twenty-fifth day of life, and good glycemic control was achieved without any notable adverse effects including hypoglycemia. We suggest that the insulin pump is a safe and effective mode for treating NDM and its early adoption may shorten the length of hospital stays in patients with NDM.

Professional values in Korean undergraduate nursing students.

Developing professional values among undergraduate nursing students is important since such values are a significant predictor of quality care, clients' recognition, and therefore nurses' job satisfaction. This study explored South Korean nursing students' perception of nursing professional values (NPV) and compared the NPV scores between groups according to participants' demographic characteristics. The study participants comprised of 529 students, mostly female (96.4%), with a mean age of 22.29years, sampled from six universities throughout the country. The NPV scores, measured with the 29-item Likert scale developed by Yeun et al. (2005), were significantly higher in students who entered nursing schools following their aptitude or desire for professional job than in those who entered the schools just because their entrance exam scores were sufficient. The NPV scores were also higher in students who were planning to pursue graduate study than in those who had not yet decided. The NPV scores were significantly different between the six regions, suggesting needs of in-depth studies to understand the underlying reasons. The NPV scores were not correlated, at the .05 level of significance, with academic year, gender, or academic performance.

Barriers to care and control of high blood pressure in Korean-American elderly.

OBJECTIVES: To identify barriers to achieving optimal management of high blood pressure (HBP) among hypertensive Korean-American elderly (KAE). METHODS: This study used data on a subsample of 146 hypertensive KAE from a total of 205 KAE in Maryland who participated in a cardiovascular health assessment study. The study group consisted of 56 males and 90 females with a mean age of 69.8 +/- 6.6 years. The PRECEDE-PROCEED model guided selection of study variables. RESULTS: Many KAE with HBP had no regular HBP care (66%) and did not achieve HBP control (92.5% of KAE with HBP and 77.6% of KAE on HBP medications). Lack of health insurance emerged as a strong barrier to receiving adequate HBP care. Other barriers to HBP care included not having a Korean doctor and not having a regular medical checkup. While 22.4% of KAE on HBP medication had controlled blood pressure (BP), those with more visits to traditional Asian medicine doctors were less likely to have achieved HBP control. CONCLUSIONS: The study unveils some of the multilevel barriers to care and control of HBP uniquely experienced by KAE and suggests the need for developing interventions to assist KAE in managing HBP.